System and method for catheterization using an intraluminal electromagnetic working capsule

ABSTRACT

There is provided a system for cardiac electromagnetic/magnetic catheterization for diagnosing and treating blood vessels of a patient. The system having at least one electromagnetic intraluminal capsule able to force its way through a narrowing blood vessel, the capsule carrying a camera allowing visualization of blood vessels of a patient. There is a portable electromagnetic tip, where the tip pulls the electromagnetic capsule by electromagnetic force, and when the magnetic tip moves along a body of a patient and pulls the intraluminal electromagnetic capsule along with it towards a narrowing blood vessel visualized by the camera, so that the capsule then treats the narrowing site and clears the blood vessel from coronary plaque. In addition working capsule can replace diseased valve in any cardiac position for either temporary or permanent needs.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a U.S. Divisional application of U.S. patentapplication Ser. No. 16/351,560, filed Mar. 13, 2019, which claims thebenefit of priority of Israeli Patent Application No. 258323 filed Mar.22, 2018, the contents of which are all incorporated herein by referencein their entirety.

TECHNICAL FIELD

The present invention relates to the field of cardiac catheterization.More particularly, the invention relates to an intraluminal magneticcapsule.

BACKGROUND ART

More than a million cardiac catheterizations are performed each year inthe United States. Several approaches to cardiac catheterization havebeen developed over the past 60 years.

Catheterization is done in order to confirm the presence of suspectedcoronary artery disease (CAD) and define its anatomical location andseverity. Once the catheterization is being performed and CAD has beenconfirmed, cardiac surgery, angioplasty or stenting may be performed.

The two most widely used ⁻techniques for cardiac catheterization involveaccess through the femoral or radial artery, or rarely, brachial artery.

Traditionally, the heart has been accessed via the femoral artery;however, in the last 2 decades, the radial artery has been more widelyused, since it (1) is easily accessible (even in obese individuals), (2)is the preferred site of access by many patients, (3) is associated witha lower incidence of port of entry related complication and (4) allowsearlier ambulation of the patient following the procedure than a femoralcatheterization.

There are some disadvantages to the regularly used procedure: manypotential complications may occur in, such as abrupt vessel closureleading to myocardial infarction, bleeding, vessel perforation,thrombosis, and more.

In addition, some patients cannot be catheterized since they areallergic to contrast dye which is used during an Angiogram, or some havea kidney disease that does not allow the administration of contrast dye.Furthermore, X-rays irradiation has a hazardous effect to both thepatient and the medical team.

More specifically, the traditional technique using catheters and wiresin blood vessels from long distance (over 100 cm) has multiplelimitations such as:1. Difficulty in navigation, 2. Poor effectivepushing and penetrating forces due to both long distance and soft tipwires. On the other hand, by using rigid edges there is a potentialcause for vessel perforation.

The basic therapeutic approach for blood vessel narrowing nowadays isdone by using balloons made of different materials-compliant or noncompliant, etc. All the balloons create temporary vessel occlusion,which may aggravate myocardial ischemia, cause vessel wall damage andpotential side branch block. These complications may lead to periprocedure, myocardial infarctions or in extreme cases even death.

Several approaches exist to solve the variety of the above mentionedrisks and disadvantages associated with cardiac catheterization. Forexample, U.S. Pat. No. 8,235,055 to Mintchev. None of them teach atechnique which doesn't rely on pushing the catheter from a largedistance from the heart all the way to the heart.

DE10161958 and Tognarelli et. Al. 2012 Magnetic propulsion andultrasound tracking of endovascular devices of Journal of roboticsurgery, 6(1) pp 5-12 disclose magnetic transporting of a capsule.CN:101961261 discloses filtering by a capsule. KR101524552 disclosesrotating drilling outwards, however not to walls of a blood vessel. U.S.Pat. No, 9,814,433 discloses catheterization.

However, none of the above discloses a replacement to the broadeningballoon.

Therefore, there is a need to provide satisfactory solutions to theaforementioned problems.

SUMMARY OF THE INVENTION

The new system for diagnosing and treating vascular pathology based on 3steps:

-   1. Creating a road mapping angiography by using intravascular    capsule camera.-   2. Using electromagnetic/magnetic forces for navigating capsule    towards the target pathology-   3. This technique use different working capsules for different    pathologies such as:-   A—blood vessel narrowing, crossing total occlusion (CTO)-   B—vessel wall shaving and stenting-   C—treating varieties of valvular pathologies-   D—On principle, single capsule has the ability to perform multiple    functions: vibration, shaving, vessel dilatation, and distal    protection (by filtering).-   1. First capsule able to force its way through the blood vessel,    carrying a camera allowing visualization of blood vessels of a    patient. This capsule provide the physician the first road mapping    angiography. After providing road map this capsule will park down    stream the artery and become a protective filter. Every parking    process is controlled by external signal which change the capsule    diameter, thus enable adherence to the vessel wall,-   A portable electromagnetic tip, wherein said tip pulls the capsule    by electromagnetic/magnetic force along the created road mapping    angiography towards the target vascular bed.

The system pulls the electromagnetic capsule by electromagnetic forceusing the principles of Magnetic Levitation (MagLev principle).

The pulling force of the magnetic tip is far greater than the pushingforce produced by the standard catheterization technique. The pullingforce makes it possible for the capsule to penetrate tight or occludedvessels combined with the basic function of the working capsule.

Working Capsules:

3A

-   The first capsule (No 1) has viewing capabilities, vessel dilation,    vibration movements and filter function.    -   For dilating blood vessel, the capsule enables to change its        diameter by electric DC nano motor for eliminating the        narrowing.    -   In case of total block (CTO-chronic total occlusion), the        pulling forces of the system will increase. Parallel to it an        internal vibrator system, can be activated. This system        increases the chances of penetration (similar to drilling in a        concrete with or without vibration) and creating first channel        in the presence of CTO.

3B

-   In the presence of calcific or highly fibrotic lesion the working    capsule may shave the plaque (No 2). Last capsule (No 3) can implant    stent in the target vessel. In contrast to the balloon dilatation    technique (blocking blood flow), the working capsule enables blood    flow in each step of its activity.

3C

-   Capsules for Valvular lesions

BACKGROUND

In western countries the incidence of valvular pathologies increaseswith age. Valvular pathologies may lead to acute or chronic heartfailure.

The main etiologies are ischemic heart disease and degenerativedisorders which affect different components of valve structure.Pulmonary hypertension from any cause may lead to right sided tricuspidregurgitation.

The major obstacles and limitation for therapy in these patients are theco-existence of additional comorbidities, ventricular dysfunction andthe presence of severe coronary artery disease.

Nowadays 30-40% from adult population who need therapeutic solution arerejected and refused by heart surgeons. Our daily practice raises theneed for temporary valve solution in order to stabilize and improvepatient's cardiac status. Unfortunately, there is no system fortemporary valve need nowadays.

Adult population who suffer from age related aortic stenosis are treatedby endovascular technique (TAVR) using either balloon or self-expandable systems. The main limitations of the actual system aredifficulties in valve position, non-ideal adherent of the new valve inthe new position leading to high percentage of peri valvular leakages.Use of stiff wires may cause damage to blood vessels or cardiacchambers, In the presence of the actual systems once we release thevalve we can't retract it or re adjust its position.

In case of tissue leaflet destruction (Biological valve) the onlysolution of the actual system is valve in valve procedure.

Our working capsule for valve disorder gives several solutions forseveral valvular issues:

-   -   1. By using our valve capsule we can mplant biological valve .        both left and right heart position for both permanent or        temporary needs.    -   2. Valve capsule navigation, position and opening are fully        controlled by external operator using a pointing device, such as        by main joystick lead. Valve frame opening/closing, and        adaptation in the destination segment will be conducted by        internal Nano motor build in the capsule. This fine tuning        adjustment will prevent peri valvular leakages.    -   3. Valve capsule can be adjusted to different valve diameters        (20-37 mm) and in any time can be retractable. This advantage        can be adopted mainly to grown kids who need valve replacement        parallel to age related anatomic changes contrary to the actual        system in case of leaflet tissue dysfunction our capsule can be        retracted, removed and a new valve capsule can be implanted.    -   4. The basic structure of the valvular capsule integrates large        fields camera which show on line valve function and potential        para valvular leakage.    -   5. In case of any structural or functional failure the implanted        valve capsule can be replaced by a new valve capsule

BRIEF DESCRIPTION OF DRAWINGS

Preferred embodiments, features, aspects and advantages of the presentinvention are described herein in conjunction with the followingdrawings:

FIGS. 1 a-c show front, rear and side views of an electromagneticcapsule according to a preferred embodiment of the present invention;

FIG. 2 shows a catheterization system according to a preferredembodiment of the present invention;

FIG. 3A shows a. first capsule led by a magnetic tip through aconstricted blood vessel;

FIG. 3B shows the first capsule deployed and anchored to the bloodvessel;

FIG. 4 a shows a second capsule led by the magnetic tip to theconstricted site

FIG. 4 b shows second capsule of FIG. 4 a shaving the plaque of theconstricted site off the blood vessel walls;

FIG. 5 a shows the plaque cleared from the constricted site flow towardsthe first capsule;

FIG. 5 b shows a cross section of the first capsule with plaque capturedin its protective filter;

FIG. 6 shows the second capsule being led out of the vessel by themagnetic tip;

FIGS. 7 a-b show a third capsule bearing a stent;

FIG. 8 a shows the third capsule being led to the constricted site;

FIG. 8 b shows the stent of the third capsule deployed and the thirdcapsule being lead out of the vessel;

FIG. 8 c is a perspective sectional view of the extendable arms and thecylindrical surface surrounding them;

FIG. 8 d is a view of the extendable arms and two secondary cylindricalsurfaces of the cylindrical surface surrounding them;

FIG. 9 a shows the first capsule being lead out of the vessel aftertrapping the atheromatous debris; and

FIG. 9 b shows the treated blood vessel having a deployed stent.

Each of FIGS. 10 a and 10 b schematically illustrates a capsule used asa cardiac valve, according to a further embodiment of the invention.

FIG. 11 a is a longitudinal-sectioned view of the capsule when beingmoved.

FIG. 11 b is a longitudinal-sectioned view of the capsule when itssupporting poles open in order to be fixed in the current position ofthe capsule.

It should be understood that the drawings are not necessarily drawn toscale.

DESCRIPTION CSF EMBODIMENTS

The present invention will be understood from the following detaileddescription of preferred embodiments (“best mode”), which are meant tobe descriptive and not limiting. For the sake of brevity, somewell-known features, methods, systems, procedures, components, circuits,and so on, are not described in detail.

Referring now to FIG. 1 a , there is shown a front view of a firstelectromagnetic intraluminal capsule 30, in a folded configuration,having a camera 32 at the front, and a protective filter 52. Firstcapsule 30 is introduced into the blood vessel 34 of a patient 36 byinjection, after beginning a catheterization procedure as any standardcatheterization.

FIG. 1 b shows a front view of first capsule 30 in an openconfiguration.

FIG. 1 c shows a side view of first capsule 30.

Capsule 30 may carry more than one camera. 32, and additional camera 32(not shown) may be located on the rear of capsule 30. The size of camera32 is between 1 to 5 mm.

Referring now to FIG. 2 , there is shown a patient 36 undergoing acatheterization procedure according to the preferred embodiment of thepresent invention, by a system for cardiac electromagneticcatheterization 40. First magnetic capsule 30 is lodged in patient's 36blood vessel 34 and a magnetic tip 42 pulls first magnetic capsule 30along vessel 34 in search for a possible narrowing site 48 (shown inFIG. 3B). Magnetic tip 42 pulls first capsule 30 by electromagneticforce using the principles of Magnetic Levitation (MagLev). The pullingforce of magnetic tip 42 is far greater than the force applied bypushing a. catheter into a blood vessel, as done in standardcatheterization procedures. If an occlusion is rigid and complex (suchas a type C lesion), a wire may not be able to penetrate it and then theoccluded blood vessel cannot be treated. By using pulling force, firstcapsule 30 can penetrate also very rigid occlusions so that the bloodvessel 34 can be treated. First capsule 30 has a vibrating engine thatgenerates a vibrating motion which assists capsule 30 in penetratingvessel narrowing 48. This is especially essential and useful for tightnarrowings that are difficult to penetrate. The vibrating motion isdefined by the electrical current of the engine: less current leads toslower speed which then leads to a larger amplitude, and vise versa.

The entire journey of capsule 30 is visualized through camera 32positioned on its front, and seen on screen 44, thus providing roadmapping of the blood vessels of the patient 36. The use of camera 32makes it unnecessary to use contrasting dyes which are normally used tovisualize the arteries, and are used with X-rays which are potentiallyhazardous to the health of both patient and medical staff. Furthermore,some patients may be allergic to the contrasting dye, or may have akidney disease and for them using contrasting dye is not an option.Computer 46 commands the movement of tip 42, which may be done via ajoystick, for example.

The size of first capsule 30 may vary so that different sized capsules30 may be used for different circumstances,

Referring now to FIG. 3A there is narrowing site 48 which is identifiedby viewing it on screen 44, the movement of tip 42 is commanded to stopso that first capsule 30 is situated downstream to narrowing site 48.First capsule 30 forces its way through narrowing site 48.

Referring now to FIG-. 3B there is shown first capsule 30 in thedeployed configuration. First capsule 30 latches onto the diameter ofblood vessel 34 via latching means illustrated here by extendable arms50 which are connected to and controlled by a. micro engine (not shown).Extendable arms 50 are folded beneath the exterior of first capsule 30and are released and spread by the micro engine, Extendable arms 50,when spread, push sections of the exterior of capsule 30 which come incontact with the blood vessel 34 and do not injure it. Extendable arms50 are connected to sections of protective filter 52 stretched betweenevery two adjacent extendable arms 50, so that when extendable arms 50are spread to latch onto the wall of blood vessel 34, filter 52 isspread as well (much like an umbrella), and the space between firstcapsule 30 and the wall of blood vessel 34 is occupied by filter 52.Spread filter 52 decreases somewhat the blood flow, but not in alife-threatening manner Protective filter 52 exists for the purpose oftrapping coronary plaque particles which are released from narrowingsite 48 downstream to filter 52. Protective filter 52 allows for bloodto flow with minimum interruption.

In the known balloon angioplasty procedure for opening a vesselnarrowing, the balloon becomes inflated and completely blocks the bloodflow, unlike the abovementioned method.

Referring now to FIG. 4 a there is shown a second capsule 54 beingintroduced to blood vessel 34 and brought to occluded site 48 by beingpulled by tip 42. Protrusions 56 formed on the surface of second capsule54 for performing shaving of narrowing site 48 in order to clear bloodvessel 34 from plaque 49. Second capsule 54 has a vibrating engine 55that generates a vibrating motion which assists capsule 54 in shavingthe occlusion.

In accordance with some embodiments of the present invention, thevibration engine 55 may be positioned anywhere within the capsule 54.

Second capsule 54 has extendable arms 50 as well as capsule 30, for theoption of latching onto blood vessel 34.

The size of second capsule 54 may vary so that different sized capsules54 may be used for different circumstances.

The shaving process may be viewed by an additional capsule (not shown)carrying a camera so that the medical team performing thecatheterization procedure can safely monitor the process and control themovement of tip 42 according to the viewed narrowing site 48. Theadditional capsule also carries a light adjacent to the camera so thatthe shaving process can be illuminated and viewed clearly.

Referring now to FIG. 5 a there is shown plaque particles 49 beingreleased from occlusion site 48 by the shaving procedure of secondcapsule 54. Plaque 49 flows with the blood flow towards first capsule 30and becomes trapped in protective filter Plaque 49 that is released tothe blood stream is likely to block a smaller artery downstream from thetreated narrowing site 48, which is liable to lead to cardiac arrest.Protective filter 52 prevents such a scenario.

FIG. 5 b shows a cross section of first capsule 30 showing plaque 49trapped in filter 52.

Referring now to FIG. 6 there is shown second capsule 54 being removedfrom treated narrowing site 48 by moving ti.p 42 pulls second capsule54.

Referring now to FIG. 8 there is shown a third capsule 58 carrying acrimped stent 60 which is to be deployed at treated narrowing site 48(shown in FIG. 8 ). In FIG. 7 b there is shown a cut out side view ofthird capsule 58 showing extendable arms 50 which deploy stent 60.

Referring now to FIG. 8 a there is shown tip 42 pulling third capsule 58to the treated narrowing site 48. All the while first capsule 30 isstill stationed downstream to the narrowing site 48.

The size of third capsule 58 may vary so that different sized capsules58 may be used for different circumstances, and for different sizedstents 60 to be carried on capsule 58.

FIG. 8 b shows stent 60 deployed at occluded site 48 in order tostabilize blood vessel 34 and maintain it. Third capsule 58 is thenpulled out of blood vessel 34 and out of the patient's body by tip 42,leaving stent 60. The deployment of stent 60 is done by activating amoving mechanism 78, such as including a motor 70 connected toc.xtendable arms 50 of capsule 30, such as by rotating a thread 72 ofcapsule 30, thereby spreading extendable arms 50, being surrounded by acylindrical surface 82 of FIG. 8 c and FIG. 8 d , which may includerounded elongated pieces 84A, 84B, etc., thereby deploying stent 60surrounding cylindrical surface 82. The activation of the motor 70 isdone by the medical staff using a user interface 74, for transmitting RE76 controlling motor 70, or any other suitable method.

Preferably three or more rounded elongated pieces 84A,84B, etc., formtogether cylindrical surface 82.

Referring now to FIG. 9 a there is shown first capsule 30 in a collapsedconfiguration, carrying filter .)2 with trapped plaque 49 particles,being pulled out of blood vessel 34 by tip 42, and out of the patient'sbody,

Referring now to FIG. 9 b there is shown blood vessel 34 ith deployedstent 60 supporting it, cleared of plaque 49 and capsules 30, 54, 58.

Each of ⁷IGS. 10 a and 10 b schematically illustrates a capsule adaptedto lie used as a cardiac valve, according to a further embodiment of theinvention.

FIG. 10 a schematicallyillustrates a perspective view of the fipsule,and FIG. 10 b is a sectioned view thereof, which exposes its internalstructure.

The capsule is designed to replace a cardiac valve or se a cardiac valvein line with the original hand damaged) cardiac valve of a patient.

The capsule comprises a one-way valve 64 at one end thereof. Thecapsule's diameter is about 4-7 mm, and the capsule's walls are flexibleenough to extend its diameter up to about 35 mm FIGS. 10 a and 10 billustrate the capsule in its expanded form. The diameter extensioncomprises a mechanism suited to this purposes, as described hereinabove.For example, the mechanism can contain an expanding skeleton, such as ofan umbrella type mechanism. Reference numeral 68 denotes a supportingpole of the skeleton.

Reference numeral 66 denotes a center that comprises a transceiver forcommunication with a remote station, a power source, a magnetic elementfor pulling the capsule, etc. Camera 34 is also installed in center 66.The purpose of the camera is to ease the placement of the capsule in thedesired place. The center in this example is in a cylinder form disposedalong the capsule, The capsule as a. whole is designed to allow freeblood flow through the capsule.

The capsule may comprise other means described above, such as a camera34, wireless communication with a remote control station (not seen inthis figure), and so on.

Firstly, the capsule is moved (via magnetic methods describedhereinabove) to the heart through the blood vessels leading to thedamaged valve. This is possible because of the low diameter, which isabout 4-7 mm.

The capsule can be inserted into the opening of the damaged valve of thepatient's heart, or placed near the defected cardiac valve, in line tothe damaged cardiac valve.

After placing the capsule in or near the damaged cardiac valve, thecapsule's diameter expands to about 35 mm by means describedhereinabove. If the capsule is inserted into the damaged cardiac valvethen the damaged valve seals the passage of the blood and allows itsflow only through the capsule. if the capsule is placed near the damagedvalve, in line with the valve, it provides proper valve operation, i.e.,does not let the blood to flow back.

Preferably, the valve of the capsule is made of an animal tissue, suchas of a cow or pig. As mentioned above, the capsule can be placed insidethe blood vessels near the infected valve, and in line with the damagedpatient's valve. The advantage of this arrangement is that when thecapsule needs to be replaced, the damaged cardiac valve can be used as abackup at the time of replacement.

It should be noted that the capsule of the present invention can replaceany cardiac valve—the mitral valve, the tricuspid valve, the aorticvalve, and the pulmonary valve.

The capsule comprises also means for fixing thereof in a desiredlocation, as described above.

Upon expanding the capsule's diameter, the other end of the capsuleopens to allow blood passage therethrough, in one way.

It also should be noted that the diameter of the valve expands alongwith the expansion of the capsule's diameter.

In the figures and/or description herein, the following referencenumerals (Reference Signs List) have been mentioned:

-   Numeral 30 denotes First capsule-   Numeral 32 denotes a camera-   Numeral 34 denotes a blood vessel-   Numeral 36 denotes a patient-   Numeral 40 denotes a system for cardiac electromagnetic    catheterization-   Numeral 42 denotes a magnetic tip-   Numeral 44 denotes a screen-   Numeral 46 denotes a Computer-   Numeral 48 denotes a narrowing site-   Numeral 50 denotes extendable arms-   Numeral 51 denotes a cylindrical surface, extendable surrounding ,    which surround the extendable arms 50-   Numeral 52 denotes a protective filter-   Numeral 54 denotes a second capsule-   Numeral 56 denotes protrusions forming a rough envelope for shaving;-   Numeral 58 denotes a third capsule-   Numeral 60 denotes a stent-   Numeral 64 denotes a one-way valve;-   numeral 66 denotes the center of the capsule, and may include    mechanisms such as a transceiver, mechanical expansion mechanism of    the capsule's diameter, and the like;-   numeral 70 denotes the motor/ micro engine;-   numeral 72 denotes a thread, being a mechanical example for    extending and diminishing extendable arms 50;-   numeral 74 denotes a user interface;-   numeral 76 denotes transmittance for controlling extendable arms 50;-   numeral 78 denotes a moving mechanism;-   numeral 80 denotes the intima wall of blood vessel 34;-   numeral 82 denotes a cylindrical surface surrounding extendable arms    50;-   numerals 84A and 84B denote rounded elongated pieces, being    secondary cylindrical surfaces of cylindrical surface 82; according    to one embodiment, three or more rounded elongated pieces form    cylindrical surface 82.    The foregoing description and illustrations of the embodiments of    the invention has been presented for the purposes of illustration.    It is not intended to be exhaustive or to limit the invention to the    above description in any form.

Any term that has been defined above and used in the claims, should beinterpreted according to this definition.

The reference numbers in the claims are not a part of the claims, butrather used for facilitating the reading thereof. These referencenumbers should not be interpreted as limiting the claims in any form.

1. A capsule configured to be injected into a blood vessel of a patient, the capsule comprising: a central portion extending along a longitudinal axis of the capsule; an extendable cylindrical surface radially surrounding the central portion and configured to be displaced between a retracted position at which the cylindrical surface lies proximal to the central portion and an extended position at which the cylindrical surface is spaced from the central portion, wherein the cylindrical surface extends parallel to the longitudinal axis at both the retracted and extended positions, the cylindrical surface being configured to, at the extended position, contact an intima wall of the blood vessel; and a moving mechanism configured to displace the cylindrical surface radially away from the central portion into its extended position thereby creating a space between the central portion and the cylindrical surface to allow flow of blood therethrough.
 2. The capsule according to claim 1, further comprising a stent positioned around the extendable cylindrical surface and configured for being implanted within the blood vessel thereby.
 3. The capsule according to claim 2, wherein the moving mechanism is configured to implant the stent within the blood vessel by the displacement of the extendable cylindrical surface into its extended position.
 4. The capsule according to claim 1, further comprising an artificial cardiac valve for replacing a patient's damaged cardiac valve.
 5. The capsule according to claim 1, further comprising an in-built filter for trapping coronary plaque particles within the blood vessel; and wherein the filter is configured to be displaced between a contracted state associated with the retracted position of the extendable cylindrical surface and an expanded state associated with the extended position of the extendable cylindrical surface.
 6. The capsule according to claim 5, wherein at the expanded state, the filter is positioned within the space to allow the flow of blood therethrough while filtering the blood by trapping the coronary plaque and/or particles therefrom.
 7. The capsule according to claim 5, wherein the moving mechanism is configured to displace the filter between its contracted state and expanded state simultaneously with displacement of the extendable cylindrical surface between its retracted position and extended position respectively.
 8. The capsule according to claim 1, further comprising a rough envelope surrounding said extendable cylindrical surface.
 9. The capsule of claim 8, wherein said rough envelope is configured for allowing shaving said intima wall of said blood vessel at the extended position of the extendable cylindrical surface.
 10. The capsule according to claim 1, wherein said extendable cylindrical surface has an external surface configured to face the intima wall when the capsule is positioned within the blood vessel, the external surface comprising protrusions configured for, at the extended position of the extendable cylindrical surface, shaving the intima wall to clear said blood vessel from plaque particles.
 11. The capsule according to claim 1, further comprising a vibration motor for generating a vibrating motion, thereby causing the capsule to vibrate; and wherein said vibration motor is configured for assisting said capsule in at least one of (a) shaving said intima wall, (b) creating a first channel in the presence of chronic total occlusion (CTO), and (c) filtering plaque from the blood.
 12. The capsule according to claim 1, further comprising a camera positioned at the central portion for capturing a view of said blood vessel and transmitting said captured view to a screen.
 13. The capsule according to claim 1, further comprising extendable arms engaging the extendable cylindrical surface from within the central portion, said moving mechanism being configured to reversible extend the extendable arms to displace the extendable cylindrical surface between its retracted and extended position.
 14. The capsule according to claim 1, wherein said extendable cylindrical surface is constituted by a plurality of discreet elongated pieces, each extending along the longitudinal axis, wherein at the retracted position of the extendable cylindrical surface, the elongated pieces are joined together, and at the extended position of the extendable cylindrical surface, the elongated pieces are separated from each other.
 15. The capsule according to claim 1, wherein the moving mechanism is configured to firmly hold the extendable cylindrical surface in its extended position even in the absence of an external force from outside the blood vessel when the capsule is positioned within the blood vessel.
 16. The capsule according to claim 1, wherein the capsule is configured, at the extended position of the extendable cylindrical surface, to be held at a location along the blood vessel as a stand-alone element even in the absence of an external force.
 17. The capsule according to claim 1, wherein the cylindrical surface is configured to, at the extended position, contact an intima wall of the blood vessel along at least a majority of length of the cylindrical surface
 18. The capsule according to claim 1, wherein the moving mechanism is positioned within the central portion and comprises a motor.
 19. The capsule according to claim 1, wherein the moving mechanism is configured to be operated from outside the blood vessel via RF (Radio Frequency) transmission when the capsule is positioned within the blood vessel.
 20. The capsule according to claim 1, wherein the capsule is configured to be fixed at a tip of a catheter for being guided within the blood vessel.
 21. The capsule according to claim 1, wherein the capsule comprises a ferromagnetic substance, and is configured for being guided within the blood vessel via electro-magnetic force. 